In the News...

Q: I've heard that many states are finding a lot of Immediate Jeopardy citations. What can we do to prevent that outcome in our facility?

A: We've been assisting facilities in several states with Immediate Jeopardy (IJ) resolutions. One of the big changes we are seeing is that when an IJ situation is cited, multiple tags are affected and so multiple IJs are identified.

It is important to keep up-to-date on what focus your state is looking at so you can monitor your systems and make sure you are in compliance. For example, it appears that Tennessee has a focus on side rails. All facilities there are now reviewing their protocols to ensure compliance.

Another example is a focus on abuse in Kentucky. Facilities in that state should be looking at their investigation and reporting protocols. We have been seeing fines of $7,500 to $10,000 per day for extended periods of time.

In many cases, if the resident had an issue that was identified before and then another incident was identified, the state will go back to the date of the original incident and assess the civil monetary penalty (CMP) from then until the resolution of the Immediate Jeopardy. This has resulted in hundreds of thousands of dollars in CMPs.

What can you do to prevent this result? First, make sure all systems are operating on evidence-based clinical standards of practice. Second, make sure your processes meet all state requirements such as reporting requirements for abuse.

Third, I strongly suggest you consider having a mock survey prior to the start of your survey window. You can have a sister facility complete the review, have your corporate nurse complete the review or, if neither of those two options is available, hire a consultant. You need to have an objective eye look at your systems and make sure you are in compliance.

Pedagogy Incorporated provides online continuing education courses to ensure your facility is practicing care based off the latest standards and according to evidenced based standards. Facilities that present with medication errors above the accepted 5% level- are frequently cited with F-tags and civil monetary penalties (CMP) as a result. Our course “Reducing Medication Errors: A Focus on the Med Pass” addresses the scope of the medication error problem, reviews appropriate medication administration practices and provides all the tools needed for pre-survey medication pass audits.

This course prepares your nurses and certified medication aides or technicians to safely administer medications to residents and ensures they understand the severe penalties a facility may face when medication error rates exceed 5%. The course is an excellent tool for management to assess their facilities current status of error rates and suggests corrections to common causative issues as well as suggestions to instill positive attitudes in staff that encourage reporting and an atmosphere of high standards of safety.